IndividualActive
Andra Talaska, PA-C
NPI 1336537877 · Medical Physician Assistant · Grand Rapids, MI
Provider details
- NPI number
- 1336537877
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- License
- 5601007275 (MI)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
743 E Beltline Ave Ne
Grand Rapids, MI 49525-6045
Phone: (616) 456-9553
Approximate (ZIP-level) locationGet directions
Mailing address
743 E Beltline Ave Ne
Grand Rapids, MI 49525-6045
Registry dates
- Enumerated
- 2015-01-07
- Last updated
- 2015-01-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.